HospitalInspections.org

Based on observation and staff interview conducted on 9/12/16, it was determined that the facility failed to conspicuously post signage, specifying the rights of individuals under section 1866 of the Act with respect to examination and treatment of emergency medical conditions and women in labor.

Findings include:

1. Observation of the 3rd Floor Bridge entrance (from the parking garage entrance) and waiting room revealed signage posted in an area that was obstructed by a large orange sign on a tripod.

2. There was no signage posted in the Emergency Department Triage Room/ Fast Track (Rooms #T1 -T5).

3. There was no signage posted in the six (6) of the Labor and Delivery Rooms.

4. Staff #1, Staff #2, and Staff #12 confirmed the above findings.

Based on staff interview, medical record review and review of the Emergency Department (ED) log, it was determined that the facility failed to maintain an accurate Emergency Department (ED) log that identifies discharge, transfer and Against Medical Advise (AMA) for all patients.

Findings include:

1. The ED log and Medical Record #2 were reviewed on 9/13/16. The ED log for Patient #2, date of service 7/3/16, indicated the patient was transferred to "Other Acute Care Hospital."

a. Review of Medical Record #2 indicated that the discharge instructions to home were signed by the patient.

b. During an interview, Staff #3 stated that the patient was not transferred to another facility. Patient #2 was a routine discharge from the facility.

3. The ED log and Medical Record #3 were reviewed on 9/13/16. The ED log for Patient #3, date of service 6/8/16, indicated that the patient signed out Against Medical Advice (AMA).

a. Review of Medical Record #3 indicated that the discharge instructions to home were signed by the patient.

4. During an interview, Staff #3 stated that the patient did not sign out AMA. The patient was a routine discharge from the facility.

5. The above was confirmed by Staff #1 and Staff #3.

Based on observation, staff interviews, review of the facility website, and review of facility documentation, it was determined that the facility failed to ensure a reasonable registration process for patients seeking treatment, unduly discouraging individuals from seeking emergency medical treatment.

Findings include:

1. Upon interview on 9/12/2016, Staff #3, the Emergency Department (ED) manager stated that the InQuicker system, which allowed patients to make an appointment for the Emergency Department through the facility website, was no longer in use as of September 1, 2016. However, Staff #3 confirmed that between 9/1/16 and 9/7/16, patients were still able to access the website with the "No Upcoming InQuicker times available" statement.

2. This was a possible deterrent to individuals seeking treatment, unduly discouraging patients from coming to the ED for evaluation/treatment.

3. Staff #1 confirmed the above findings.